Romidepsin formulations and uses thereof

ABSTRACT

Provided herein are liquid concentrate formulations of romidepsin. Also provided are methods for producing these formulations and uses thereof. In one embodiment, the formulation comprises romidepsin, polyethylene glycol, etanol and a citrate buffer. In another embodiment, the formulation comprises romidepsin, polyethylene glycol, etanol and an acetate buffer.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. Ser. No.14/944,126, filed Nov. 17, 2015, now allowed, which is a continuationapplication of U.S. Ser. No. 14/581,999 filed Dec. 23, 2014, nowabandoned, which claims the benefit of priority to U.S. Provisionalapplication Ser. No. 61/921,361 filed Dec. 27, 2013, the disclosures ofwhich are incorporated by reference herein in their entireties.

FIELD

Provided herein are liquid formulations of romidepsin. Also provided aremethods for producing these formulations and uses thereof.

BACKGROUND

Cancer is a major public health problem in the United States and in theworld. Currently, one in 4 deaths in the United States is due to cancer.Each year, the American Cancer Society estimates the numbers of newcancer cases and deaths expected in the United States in the currentyear and compiles the most recent data on cancer incidence, mortality,and survival based on incidence data from the National Cancer Institute,the Centers for Disease Control and Prevention, and the North AmericanAssociation of Central Cancer Registries and mortality data from theNational Center for Health Statistics. A total of 1,596,670 new cancercases and 571,950 deaths from cancer were projected to occur in theUnited States in 2011. Overall cancer incidence rates were stable sincelate 1990s. The reduction in the overall cancer death rates since 1990in men and 1991 in women translated to the avoidance of about 898,000deaths from cancer. Despite an obvious progress, approximately 560,000people died of cancer in 2006 in the United States alone. Aging of thegeneral population and development of new forms of cancer contribute tothe problem.

Romidepsin has been shown to have anticancer activities. The drug isapproved in the U.S. for treatment of cutaneous T-cell lymphoma (CTCL)and peripheral T-cell lymphoma (PTCL), and is currently being tested,for example, for use in treating patients with other hematologicalmalignancies (e.g, multiple myeloma, etc.) and solid tumors (e.g.,prostate cancer, pancreatic cancer, etc.). It is thought to act byselectively inhibiting deacetylases (e.g., histone deacetylase, tubulindeacetylase), promising new targets for development of a new class ofanti-cancer therapies (Bertino & Otterson, Expert Opin Investig Drugs20(8):11151-1158, 2011). One mode of action involves the inhibition ofone or more classes of histone deacetylases (HDAC).

As cancer remains a major worldwide public health problem, there is acontinued need for effective therapies to treat cancer.

SUMMARY

In one embodiment, provided herein is a romidepsin formulation. In oneembodiment, the formulation is a liquid concentrate formulation. In oneembodiment, the formulation is a liquid concentrate formulation fordilution. In one embodiment, a liquid concentrate formulation fordilution is formulated in a solvent system. In one embodiment, thesolvent system comprises a citrate buffer. In another embodiment, thesolvent system comprises an acetate buffer. In one embodiment, aromidepsin formulation is an injectable formulation.

In one embodiment, provided herein are methods to treat proliferativediseases using a romidepsin formulation provided herein. In someembodiments, provided herein are methods to treat cancer. In someembodiments, cancers include, but are not limited to, carcinomas,sarcomas, leukemias, lymphomas and the like. In certain embodiments, thecancer is a hematological malignancy. In certain embodiments, the canceris a solid tumor.

In one embodiment, provided are methods of producing a romidepsinformulation.

DETAILED DESCRIPTION

Definitions

As used in the specification and the accompanying claims, the indefinitearticles “a” and “an” and the definite article “the” include plural aswell as singular referents, unless the context clearly dictatesotherwise.

As used herein, and unless otherwise specified, the term “about” or“approximately” means an acceptable error for a particular value asdetermined by one of ordinary skill in the art, which depends in part onhow the value is measured or determined. In certain embodiments, theterm “about” or “approximately” means within 1, 2, 3, or 4 standarddeviations. In certain embodiments, the term “about” or “approximately”means within 30%, 25%, 20%, 15%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%,1%, 0.5%, 0.1%, or 0.05% of a given value or range.

As used herein, and unless otherwise specified, the terms “treat,”“treating” and “treatment” refer to the eradication or amelioration of adisease or disorder, or of one or more symptoms associated with thedisease or disorder. In certain embodiments, the terms refer tominimizing the spread or worsening of the disease or disorder resultingfrom the administration of one or more prophylactic or therapeuticagents to a subject with such a disease or disorder. In someembodiments, the terms refer to the administration of a compound ordosage form provided herein, with or without one or more additionalactive agent(s), after the diagnosis or the onset of symptoms of theparticular disease.

As used herein, and unless otherwise specified, the terms “prevent,”“preventing” and “prevention” refer to the prevention of the onset,recurrence or spread of a disease or disorder, or of one or moresymptoms thereof. In certain embodiments, the terms refer to thetreatment with or administration of a compound or dosage form providedherein, with or without one or more other additional active agent(s),prior to the onset of symptoms, particularly to subjects at risk ofdisease or disorders provided herein. The terms encompass the inhibitionor reduction of a symptom of the particular disease. In certainembodiments, subjects with familial history of a disease are potentialcandidates for preventive regimens. In certain embodiments, subjects whohave a history of recurring symptoms are also potential candidates forprevention. In this regard, the term “prevention” may be interchangeablyused with the term “prophylactic treatment.”

As used herein, and unless otherwise specified, the terms “manage,”“managing” and “management” refer to preventing or slowing theprogression, spread or worsening of a disease or disorder, or of one ormore symptoms thereof. Often, the beneficial effects that a subjectderives from a prophylactic and/or therapeutic agent do not result in acure of the disease or disorder. In this regard, the term “managing”encompasses treating a subject who had suffered from the particulardisease in an attempt to prevent or minimize the recurrence of thedisease.

As used herein, and unless otherwise specified, “amelioration” of thesymptoms of a particular disorder by administration of a particularpharmaceutical composition refers to any lessening, whether permanent ortemporary, lasting or transient, that can be attributed to or associatedwith the administration of the composition.

As used herein, and unless otherwise specified, the term“therapeutically effective amount” or “effective amount” of a compoundmeans an amount sufficient to provide a therapeutic benefit in thetreatment or management of a disease or disorder, or to delay orminimize one or more symptoms associated with the disease or disorder. A“therapeutically effective amount” or “effective amount” of a compoundmeans an amount of therapeutic agent, alone or in combination with oneor more other agent(s), which provides a therapeutic benefit in thetreatment or management of the disease or disorder. The terms“therapeutically effective amount” and “effective amount” can encompassan amount that improves overall therapy, reduces, delays, or avoidssymptoms or causes of disease or disorder, or enhances the therapeuticefficacy of another therapeutic agent.

As used herein, and unless otherwise specified, a “prophylacticallyeffective amount” of a compound is an amount sufficient to prevent adisease or disorder, or prevent its recurrence. A prophylacticallyeffective amount of a compound means an amount of therapeutic agent,alone or in combination with one or more other agent(s), which providesa prophylactic benefit in the prevention of the disease. The term“prophylactically effective amount” can encompass an amount thatimproves overall prophylaxis or enhances the prophylactic efficacy ofanother prophylactic agent.

As used herein, and unless otherwise specified, the term “subject” isdefined herein to include animals such as mammals, including, but notlimited to, primates (e.g., humans), cows, sheep, goats, horses, dogs,cats, rabbits, rats, mice, and the like. In specific embodiments, thesubject is a human. The terms “subject” and “patient” are usedinterchangeably herein in reference, for example, to a mammaliansubject, such as a human. In particular embodiments, a subject havingcancer is a subject who has been previously diagnosed as having cancer.

As used herein, and unless otherwise specified, “neoplasm” is anabnormal mass of tissue as a result of neoplasia. The growth ofneoplastic cells exceeds and is not coordinated with that of the normaltissues around it. The growth persists in the same excessive manner evenafter cessation of the stimuli. It usually causes a lump or tumor.Neoplasms may be benign, pre-malignant (carcinoma in situ) or malignant(cancer).

As used herein, and unless otherwise specified, “tumor” refers to allneoplastic cell growth and proliferation, whether malignant or benign,and all pre-cancerous and cancerous cells and tissues. As used herein,and unless otherwise specified, “neoplastic” refers to any form ofderegulated or unregulated cell growth, whether malignant or benign,resulting in abnormal tissue growth. Thus, “neoplastic cells” includemalignant and benign cells having deregulated or unregulated cellgrowth.

As used herein, and unless otherwise specified, the terms “cancer” and“cancerous” refer to or describe the physiological condition in mammalsthat is typically characterized by unregulated cell growth. Examples ofcancer include, but are not limited to, lymphoma, leukemia, and solidtumors, such as, for example, lung cancer. In one embodiment, the term“cancer” as used herein includes, but is not limited to, solid tumorsand blood-borne tumors. The term “cancer” refers to disease of skintissues, organs, blood, and vessels, including, but not limited to,cancers of the bladder, bone or blood, brain, breast, cervix, chest,colon, endometrium, esophagus, eye, head, kidney, liver, lymph nodes,lung, mouth, neck, ovaries, pancreas, prostate, rectum, stomach, testis,throat, and uterus. Specific cancers include, but are not limited to,advanced malignancy, amyloidosis, neuroblastoma, meningioma, atypicalmeningioma, hemangiopericytoma, multiple brain metastase, glioblastomamultiforms, glioblastoma, brain stem glioma, poor prognosis malignantbrain tumor, malignant glioma, recurrent malignant glioma, anaplasticastrocytoma, anaplastic oligodendroglioma, neuroendocrine tumor, rectaladenocarcinoma, Dukes C & D colorectal cancer, unresectable colorectalcarcinoma, metastatic hepatocellular carcinoma, Kaposi's sarcoma,karyotype acute myeloblastic leukemia, Hodgkin's lymphoma, non-Hodgkin'slymphoma, cutaneous T-Cell lymphoma, cutaneous B-Cell lymphoma, diffuselarge B-Cell lymphoma, low grade follicular lymphoma, metastaticmelanoma (localized melanoma, including, but not limited to, ocularmelanoma), malignant mesothelioma, malignant pleural effusionmesothelioma syndrome, peritoneal carcinoma, papillary serous carcinoma,gynecologic sarcoma, soft tissue sarcoma, scelroderma, cutaneousvasculitis, Langerhans cell histiocytosis, leiomyosarcoma,fibrodysplasia ossificans progressiva, hormone refractory prostatecancer, resected high-risk soft tissue sarcoma, unrescectablehepatocellular carcinoma, Waldenstrom's macroglobulinemia, smolderingmyeloma, indolent myeloma, fallopian tube cancer, androgen independentprostate cancer, androgen dependent stage IV non-metastatic prostatecancer, hormone-insensitive prostate cancer, chemotherapy-insensitiveprostate cancer, papillary thyroid carcinoma, follicular thyroidcarcinoma, medullary thyroid carcinoma, and leiomyoma. In a specificembodiment, the cancer is metastatic. In another embodiment, the canceris refractory or resistant to chemotherapy or radiation.

As used herein, and unless otherwise specified, the term “proliferative”disorder or disease refers to unwanted cell proliferation of one or moresubset of cells in a multicellular organism resulting in harm (i.e.,discomfort or decreased life expectancy) to the multicellular organism.For example, as used herein, proliferative disorder or disease includesneoplastic disorders and other proliferative disorders.

As used herein, and unless otherwise specified, the term “relapsed”refers to a situation where a subject, that has had a remission ofcancer after a therapy, has a return of cancer cells.

As used herein, and unless otherwise specified, the term “refractory” or“resistant” refers to a circumstance where a subject, even afterintensive treatment, has residual cancer cells in the body.

As used herein, and unless otherwise specified, the term “drugresistance” refers to the condition when a disease does not respond tothe treatment of a drug or drugs. Drug resistance can be eitherintrinsic, which means the disease has never been responsive to the drugor drugs, or it can be acquired, which means the disease ceasesresponding to a drug or drugs that the disease had previously respondedto. In certain embodiments, drug resistance is intrinsic. In certainembodiments, the drug resistance is acquired.

As used herein, and unless otherwise specified, the term “anticanceragent” or “cancer therapeutic agent” is meant to include histonedeacetylase (HDAC) inhibitors, including, but not limited to,romidepsin, anti-proliferative agents and chemotherapeutic agents,including, but not limited to, antimetabolites (e.g., 5-fluoro uracil,methotrexate, fludarabine, cytarabine (also known as cytosinearabinoside or Ara-C), and high dose cytarabine), antimicrotubule agents(e.g., vinca alkaloids, such as vincristine and vinblastine; andtaxanes, such as paclitaxel and docetaxel), alkylating agents (e.g.,mechlorethamine, chlorambucil, cyclophosphamide, melphalan, melphalan,ifosfamide, carmustine, azacitidine, decitabine, busulfan,cyclophosphamide, dacarbazine, ifosfamide, and nitrosoureas, such ascarmustine, lomustine, bischloroethylnitrosurea, and hydroxyurea),platinum agents (e.g., cisplatin, carboplatin, oxaliplatin, satraplatin(JM-216), and CI-973), anthracyclines (e.g., doxorubicin anddaunorubicin), antitumor antibiotics (e.g., mitomycin, bleomycin,idarubicin, adriamycin, daunomycin (also known as daunorubicin,rubidomycin, or cerubidine), and mitoxantrone), topoisomerase inhibitors(e.g., etoposide and camptothecins), purine antagonists or pyrimidineantagonists (e.g., 6-mercaptopurine, 5-fluorouracil, cytarabine,clofarabine, and gemcitabine), cell maturing agents (e.g., arsenictrioxide and tretinoin), DNA repair enzyme inhibitors (e.g.,podophyllotoxines, etoposide, irinotecan, topotecan, and teniposide),enzymes that prevent cell survival (e.g., asparaginase andpegaspargase), histone deacetylase inhibitors (e.g., vorinostat), anyother cytotoxic agents (e.g., estramustine phosphate, dexamethasone,prednimustine, and procarbazine), hormones (e.g., dexamethasone,prednisone, methylprednisolone, tamoxifen, leuprolide, flutamide, andmegestrol), monoclonal antibodies (e.g., gemtuzumab ozogamicin,alemtuzumab, rituximab, and yttrium-90-ibritumomab tiuxetan),immuno-modulators (e.g., thalidomide and lenalidomide), Bcr-Abl kinaseinhibitors (e.g., AP23464, AZD0530, CGP76030, PD180970, SKI-606,imatinib, BMS354825 (dasatinib), AMN107 (nilotinib), and VX-680),hormone agonists or antagonists, partial agonists or partialantagonists, kinase inhibitors, surgery, radiotherapy (e.g.,gamma-radiation, neutron bean radiotherapy, electron beam radiotherapy,proton therapy, brachytherapy, and systemic radioactive isotopes),endocrine therapy, biological response modifiers (e.g., interferons,interleukins, and tumor necrosis factor), hyperthermia and cryotherapy,and agents to attenuate any adverse effects (e.g., antiemetics).

As used herein, and unless otherwise specified, the terms“co-administration” and “in combination with” include the administrationof two or more therapeutic agents simultaneously, concurrently orsequentially within no specific time limits unless otherwise indicated.In one embodiment, the agents are present in the cell or in thesubject's body at the same time or exert their biological or therapeuticeffect at the same time. In one embodiment, the therapeutic agents arein the same composition or unit dosage form. In other embodiments, thetherapeutic agents are in separate compositions or unit dosage forms. Incertain embodiments, a first agent can be administered prior to (e.g., 5minutes, 15 minutes, 30 minutes, 45 minutes, 1 hour, 2 hours, 4 hours, 6hours, 12 hours, 24 hours, 48 hours, 72 hours, 96 hours, 1 week, 2weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 8 weeks, or 12 weeks before),essentially concomitantly with, or subsequent to (e.g., 5 minutes, 15minutes, 30 minutes, 45 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12hours, 24 hours, 48 hours, 72 hours, 96 hours, 1 week, 2 weeks, 3 weeks,4 weeks, 5 weeks, 6 weeks, 8 weeks, or 12 weeks after) theadministration of a second therapeutic agent.

As used herein, and unless otherwise specified, the terms “composition,”“formulation,” and “dosage form” are intended to encompass productscomprising the specified ingredient(s) (in the specified amounts, ifindicated), as well as any product(s) which result, directly orindirectly, from combination of the specified ingredient(s) in thespecified amount(s).

As used herein, and unless otherwise specified, the term “excipient”refers to a pharmacologically inactive substance used as a carrier forthe active ingredient of a medication or as a bulking agent to allow forconvenient and accurate dosage of an active ingredient.

As used herein, and unless otherwise specified, the term“pharmaceutically acceptable carrier,” “pharmaceutically acceptableexcipient,” “physiologically acceptable carrier,” or “physiologicallyacceptable excipient” refers to a pharmaceutically-acceptable material,composition, or vehicle, such as a liquid or solid filler, diluent,excipient, solvent, or encapsulating material. In one embodiment, eachcomponent is “pharmaceutically acceptable” in the sense of beingcompatible with the other ingredients of a pharmaceutical formulation,and suitable for use in contact with the tissue or organ of humans andanimals without excessive toxicity, irritation, allergic response,immunogenicity, or other problems or complications, commensurate with areasonable benefit/risk ratio. In one embodiment, by “pharmaceutical” or“pharmaceutically acceptable” it is meant that any diluent(s),excipient(s) or carrier(s) in the composition, formulation, or dosageform are compatible with the other ingredient(s) and not deleterious tothe recipient thereof. See, e.g., Remington, The Science and Practice ofPharmacy, 21st Edition; Lippincott Williams & Wilkins: Philadelphia,Pa., 2005; Handbook of Pharmaceutical Excipients, 5th Edition; Rowe etal., ed., The Pharmaceutical Press and the American PharmaceuticalAssociation: 2005; and Handbook of Pharmaceutical Additives, 3rdEdition; Ash and Ash ed., Gower Publishing Company: 2007; PharmaceuticalPreformulation and Formulation, Gibson ed., CRC Press LLC: Boca Raton,Fla., 2004.

As used herein, and unless otherwise specified, the term“pharmaceutically acceptable salts” is meant to include salts of activecompounds which are prepared with relatively nontoxic acids. Acidaddition salts can be obtained by contacting the neutral form of suchcompounds with a sufficient amount of the desired acid, either neat orin a suitable inert solvent. Examples of pharmaceutically acceptableacid addition salts include those derived from inorganic acids likehydrochloric, hydrobromic, nitric, carbonic, monohydrogencarbonic,phosphoric, monohydrogenphosphoric, dihydrogenphosphoric, sulfuric,monohydrogensulfuric, hydriodic, or phosphorous acids and the like, aswell as the salts derived from relatively nontoxic organic acids likeacetic, propionic, isobutyric, maleic, malonic, benzoic, succinic,suberic, fumaric, mandelic, phthalic, benzenesulfonic, p-tolylsulfonic,citric, tartaric, methanesulfonic, and the like. Also included are saltsof amino acids such as arginate and the like, and salts of organic acidslike glucuronic or galactunoric acids and the like (see, for example,Berge, et al. (1977)Pharm. Sci. 66:1-19).

A pharmaceutically acceptable salt form of a compound can be prepared insitu during the final isolation and purification of the compound, orseparately by reacting the free base functionality with a suitableorganic or inorganic acid. Examples of typical pharmaceuticallyacceptable, nontoxic acid addition salts are salts of an amino groupformed with inorganic acids such as hydrochloric acid, hydrobromic acid,phosphoric acid, sulfuric acid, and perchloric acid, or with organicacids such as acetic acid, oxalic acid, maleic acid, tartaric acid,citric acid, succinic acid, or malonic acid or by using other methodsused in the art such as ion exchange. Other pharmaceutically acceptablesalts can include adipate, alginate, ascorbate, aspartate,benzenesulfonate, benzoate, bisulfate, borate, butyrate, camphorate,camphorsulfonate, citrate, cyclopentanepropionate, digluconate,dodecylsulfate, ethanesulfonate, formate, fumarate, glucoheptonate,glycerophosphate, gluconate, hernisulfate, heptanoate, hexanoate,hydroiodide, 2-hydroxy-ethanesulfonate, lactobionate, lactate, laurate,lauryl sulfate, malate, maleate, malonate, methanesulfonate,2-naphthalenesulfonate, nicotinate, nitrate, oleate, oxalate, palmitate,pamoate, pectinate, persulfate, 3-phenylpropionate, phosphate, picrate,pivalate, propionate, stearate, succinate, sulfate, tartrate,thiocyanate, p-toluenesulfonate, undecanoate, valerate salts, and thelike. Representative alkali or alkaline earth metal salts includesodium, lithium, potassium, calcium, magnesium, and the like. Furtherpharmaceutically acceptable salts can include, when appropriate,nontoxic ammonium, quaternary ammonium, and amine cations formed usingcounterions such as halide, hydroxide, carboxylate, sulfate, phosphate,nitrate, lower alkyl sulfonate, and aryl sulfonate.

The neutral forms of the compounds may be regenerated by contacting thesalt with a base or acid and isolating the parent compound in theconventional manner. The parent form of the compound differs from thevarious salt forms in certain physical properties, such as solubility inpolar solvents, but otherwise the salts are equivalent to the parentform of the compound for the purposes of the present invention.

As used herein, and unless otherwise specified, the terms, “polymorphs”and “polymorphic forms” and related terms refer to one of a variety ofdifferent crystal structures that can be adopted by a particularcompound. In some embodiments, polymorphs occur when a particularchemical compound can crystallize in more than one structuralarrangement. Different polymorphs may have different physical propertiessuch as, for example, melting temperatures, heats of fusion,solubilities, dissolution rates and/or vibrational spectra as a resultof the arrangement or conformation of the molecules in the crystallattice. The differences in physical properties exhibited by polymorphsaffect pharmaceutical parameters such as storage stability,compressibility and density (important in formulation and productmanufacturing), and dissolution rates (an important factor indetermining bioavailability). Differences in stability can result fromchanges in chemical reactivity (e.g., differential oxidation, such thata dosage form discolors more rapidly when comprised of one polymorphthan when comprised of another polymorph) or mechanical changes (e.g.,tablets crumble on storage as a kinetically favored polymorph convertsto thermodynamically more stable polymorph) or both (e.g., tablets ofone polymorph are more susceptible to breakdown at high humidity). As aresult of solubility/dissolution differences, in the extreme case, somepolymorphic transitions may result in lack of potency or, at the otherextreme, toxicity. In addition, the physical properties of the crystalmay be important in processing, for example, one polymorph might be morelikely to form solvates or might be difficult to filter and wash free ofimpurities (i.e., particle shape and size distribution might bedifferent between one polymorph relative to the other).

As used herein, and unless otherwise specified, the term, “solvate”refers to a crystal form of a substance which contains solvent.

As used herein, and unless otherwise specified, the term “hydrate”refers to a crystal form adopted by a particular compound in whicheither a stoichiometric or non-stoichiometric amount of water isincorporated into the crystal lattice.

As used herein, and unless otherwise specified, the term “prodrug”refers to structurally modified forms of the compound that readilyundergo chemical changes under physiological conditions to provide thecompound. Additionally, prodrugs can be converted to the compound bychemical or biochemical methods in an ex vivo environment. Prodrugs areoften useful because, in some situations, they may be easier toadminister than the compound, or parent drug. They may, for instance, bebioavailable by oral administration whereas the parent drug is not. Theprodrug may also have improved solubility in pharmaceutical compositionsover the parent drug. A wide variety of prodrug derivatives are known inthe art, such as those that rely on hydrolytic cleavage or oxidativeactivation of the prodrug. An example, without limitation, of a prodrugwould be a compound which is administered as an ester (the “prodrug”),but then is metabolically hydrolyzed to the carboxylic acid, the activeentity.

As used herein, and unless otherwise specified, the term “anhydrous”refers to a form of a compound that is substantially free of water. Oneof skill in the art will appreciate that an anhydrous solid can containvarious amounts of residual water wherein that water is not incorporatedin the crystalline lattice. Such incorporation of residual water candepend upon a compound's hygroscopicity and storage conditions.

As used herein, and unless otherwise specified, the term “isostructural”or “isostructure” refers to two or more solid forms of a compoundcontaining essentially the same three-dimensional arrangement ofgeometrically similar structural units. In some embodiments,“isostructural” forms show with similar or identical unit celldimensions, the same space group, and similar or identical atomiccoordinates for common atoms. In some embodiments, “isostructural” formshave the same structure, but not the same cell dimensions nor the samechemical composition, and have comparable variability in their atomiccoordinates to that of the cell dimensions and chemical composition.

As used herein, and unless otherwise specified, the term “lyophilize”refers to the process of isolating a solid substance from solutionand/or removal of solvent. In some embodiments, this may be achieved byvarious techniques known to one of skill in the art, including, forexample, evaporation (e.g., under vaccum, for example by rotaryevaporation), freeze drying, and/or freezing the solution and vaporizingfrozen solvent away under vacuum conditions, etc.

As used herein, and unless otherwise specified, the term “parenteral”includes subcutaneous, intravenous, intramuscular, intra-artricular,intra-synovial, intrasternal, intrathecal, intrahepatic, intralesionaland intracranial injection or infusion techniques.

As used herein, and unless otherwise specified, the term “substantiallyfree of” means containing no more than an insignificant amount. In someembodiments, a composition or preparation is “substantially free of” arecited element if it contains less than 5%, 4%, 3%, 2%, or 1%, byweight of the element. In some embodiments, the composition orpreparation contains less than 0.9%, 0.8%, 0.7%, 0.6%, 0.5%, 0.4%, 0.3%,0.2%, 0.1% or less of the recited element. In some embodiments, thecomposition or preparation contains an undetectable amount of therecited element.

As used herein, and unless otherwise specified, the expression “unitdose” refers to a physically discrete unit of a formulation appropriatefor a subject to be treated (e.g., for a single dose); each unitcontaining a predetermined quantity of an active agent selected toproduce a desired therapeutic effect (it being understood that multipledoses may be required to achieve a desired or optimum effect),optionally together with a pharmaceutically acceptable carrier, whichmay be provided in a predetermined amount. The unit dose may be, forexample, a volume of liquid (e.g,. an acceptable carrier) containing apredetermined quantity of one or more therapeutic agents, apredetermined amount of one or more therapeutic agents in solid form, asustained release formulation or drug delivery device containing apredetermined amount of one or more therapeutic agents, etc. It will beappreciated that a unit dose may contain a variety of components inaddition to the therapeutic agent(s). For example, acceptable carriers(e.g., pharmaceutically acceptable carriers), diluents, stabilizers,buffers, preservatives, etc., may be included as described infra. Itwill be understood, however, that the total daily usage of a formulationof the present disclosure will be decided by the attending physicianwithin the scope of sound medical judgment. The specific effective doselevel for any particular subject or organism may depend upon a varietyof factors including the disorder being treated and the severity of thedisorder; activity of specific active compound employed; specificcomposition employed; age, body weight, general health, sex and diet ofthe subject; time of administration, and rate of excretion of thespecific active compound employed; duration of the treatment; drugsand/or additional therapies used in combination or coincidental withspecific compound(s) employed, and like factors well known in themedical arts.

As used herein, and unless otherwise specified, a compound describedherein is intended to encompass all possible stereoisomers, unless aparticular stereochemistry is specified. Where structural isomers of acompound are interconvertible via a low energy barrier, the compound mayexist as a single tautomer or a mixture of tautomers. This can take theform of proton tautomerism; or so-called valence tautomerism in thecompound.

Romidepsin

Romidepsin is a natural product which was isolated from Chromobacteriumviolaceum by Fujisawa Pharmaceuticals (Published Japanese PatentApplication Hei 7 (1995)-64872; and U.S. Pat. No. 4,977,138, issued Dec.11, 1990, each of which is incorporated herein by reference). Variouspreparations and purifications of romidepsin are described in PCTPublication WO 02/20817, which is incorporated herein by reference.

Romidepsin is a bicyclic peptide consisting of four amino acid residues(D-valine, D-cysteine, dehydrobutyrine, and L-valine) and a novel acid(3-hydroxy-7-mercapto-4-heptenoic acid), which contains both amide andester bonds. Romidepsin can be obtained from C. violaceum usingfermentation. It can also be prepared by synthetic or semi-syntheticmeans. The total synthesis of romidepsin reported by Kahn et al. (J. Am.Chem. Soc. 118:7237-7238, 1996) involves 14 steps and yields romidepsinin 18% overall yield. The structure of romidepsin is shown below(formula I):

Romidepsin has been shown to have anti-microbial, immunosuppressive, andanti-tumor activities. In the US, it is approved for the treatment ofpatients with cutaneous T-cell lymphoma (CTCL) and peripheral T-celllymphoma (PTCL). It is currently being tested for multiple myeloma andsolid tumors (e.g., prostate cancer, pancreatic cancer, etc.) and isthought to act by selectively inhibiting deacetylases (e.g., histonedeacetylase, tubulin deacetylase) (Nakajima et al., Exp Cell Res241:126-133, 1998). One mode of action of romidepsin involves theinhibition of one or more classes of histone deacetylases (HDAC).Preparations and purification of romidepsin is described, for example,in U.S. Pat. No. 4,977,138 and International PCT Application PublicationWO 02/20817, each of which is incorporated herein by reference.

Exemplary forms of romidepsin include, but are not limited to, salts,esters, pro-drugs, isomers, stereoisomers (e.g., enantiomers,diastereomers), tautomers, protected forms, reduced forms, oxidizedforms, derivatives, and combinations thereof, with the desired activity(e.g., deacetylase inhibitory activity, aggressive inhibition,cytotoxicity). In certain embodiments, romidepsin is a pharmaceuticalgrade material and meets the standards of the U.S. Pharmacopoeia,Japanese Pharmacopoeia, or European Pharmacopoeia. In certainembodiments, the romidepsin is at least 95%, at least 98%, at least 99%,at least 99.9%, or at least 99.95% pure. In certain embodiments, theromidepsin is at least 95%, at least 98%, at least 99%, at least 99.9%,or at least 99.95% monomeric. In certain embodiments, no impurities aredetectable in the romidepsin materials (e.g., oxidized material, reducedmaterial, dimerized or oligomerized material, side products, etc.).Romidepsin typically includes less than 1.0%, less than 0.5%, less than0.2%, or less than 0.1% of total other unknowns. The purity ofromidepsin may be assessed by appearance, HPLC, specific rotation, NMRspectroscopy, IR spectroscopy, UV/Visible spectroscopy, powder x-raydiffraction (XRPD) analysis, elemental analysis, LC-mass spectroscopy,or mass spectroscopy.

In one embodiment, the formulation contains a derivative of romidepsin.

In one embodiment, the derivative of romidepsin is of the formula (II):

wherein

n is 1, 2, 3 or 4;

n is 0, 1, 2 or 3;

p and q are independently 1 or 2;

X is 0, NH, or NR₈;

R₁, R₂, and R₃ are independently hydrogen, unsubstituted or substituted,branched or unbranched, cyclic or acyclic aliphatic; unsubstituted orsubstituted, branched or unbranched, cyclic or acyclic heteroaliphatic;unsubstituted or substituted aryl; or unsubstituted or substitutedheteroaryl; and R₄, R₅, R₆, R₇ and R₈ are independently hydrogen, orsubstituted or unsubstituted, branched or unbranched, cyclic or acyclicaliphatic; and pharmaceutically acceptable forms thereof.

In one embodiment, m is 1, n is 1, p is 1, q is 1, X is 0, R₁, R₂, andR₃ are unsubstituted or substituted, branched or unbranched acyclicaliphatic. In one embodiment, R₄, R₅, R₆ and R₇ are all hydrogen. In oneembodiment, the derivative of romidepsin is of the formula (III):

wherein:

m is 1, 2, 3 or 4;

n is 0, 1, 2 or 3;

q is 2 or 3;

X is 0, NH, or NR₈;

Y is ORB, or SR₈;

R₂ and R₃ are independently hydrogen, unsubstituted or substituted,branched or unbranched, cyclic or acyclic aliphatic, unsubstituted orsubstituted, branched or unbranched, cyclic or acylic heteroaliphatic,unsubstituted or substituted aryl or unsubstituted or substitutedheteroaryl;

R₄, R₅, R₆, R₇ and R₈ are independently selected from hydrogen orsubstituted or unsubstituted, branched or unbranched, cyclic or acyclicaliphatic, and pharmaceutically acceptable forms thereof.

In one embodiment, m is 1, n is 1, q is 2, X is NH and R₂ and R₃ areunsubstituted or substituted, branched or unbranched, acyclic aliphatic.In one embodiment, R₄, R₅, R₆ and R₇ are all hydrogen.

In one embodiment, the derivative of romidepsin is of the formula (IV):

wherein:

A is a moiety that is cleaved under physiological conditions to yield athiol group and includes, for example, an aliphatic or aromatic acylmoiety (to form a thioester bond), an aliphatic or aromatic thioxy (toform a disulfide bond), or the like, and pharmaceutically acceptableforms thereof. Such aliphatic or aromatic groups can include asubstituted or unsubstituted, branched or unbranched, cyclic or acyclicaliphatic group, a substituted or unsubstituted aromatic group, asubstituted or unsubstituted heteroaromatic group, or a substituted orunsubstituted heterocyclic group. A can be, for example, —COR₁,—SC(=0)-0-R₁, or —SR₂;

R₁ is independently hydrogen, substituted or unsubstituted amino,substituted or unsubstituted, branched or unbranched, cyclic or acyclicaliphatic, substituted or unsubstituted aromatic group, substituted orunsubstituted heteroaromatic group, or a substituted or unsubstitutedheterocyclic group. In one embodiment, R₁ is hydrogen, methyl, ethyl,n-propyl, isopropyl, n-butyl, isobutyl, benzyl, or bromobenzyl;

R₂ is a substituted or unsubstituted, branched or unbranched, cyclic oracyclic aliphatic group, a substituted or unsubstituted aromatic group,a substituted or unsubstituted heteroaromatic group, or a substituted orunsubstituted heterocyclic group.

In one embodiment, R₂ is methyl, ethyl, 2-hydroxyethyl, isobutyl, afatty acid, a substituted or unsubstituted benzyl, a substituted orunsubstituted aryl, cysteine, homocysteine, or glutathione.

In one embodiment, the derivatives of romidepsin are of formulae (V) or(V′):

wherein:

each of R₁, R₂, R₃ and R₄ is the same or different and represent anamino acid side chain moiety;

each R₆ is the same or different and represents hydrogen or(C₁-C₄)alkyl; and

Pr¹ and Pr² are the same or different and represent hydrogen orthiol-protecting group.

In one embodiment, the amino acid side chain moieties are those derivedfrom natural amino acids. In one embodiment, the amino acid side chainmoieties are those derived from unnatural amino acids.

In one embodiment, each amino acid side chain is a moiety selected fromhydrogen, (C₁-C₆)alkyl, (C₂-C₆)alkenyl, -L-O—C(0)-R′, -L-C(0)-0-R″,-L-A, -L-NR″R″, -L-Het-C(0)-Het-R″, and -L-Het-R″, wherein L is a(C₁-C₆)alkylene group, A is phenyl or a 5- or6-membered heteroarylgroup, each R′ is the same or different and represents (C₁-C₄)alkyl,each R″ is the same or different and represent H or (C₁-C₆)alkyl, each-Het- is the same or different and is a heteroatom spacer selected from-0-, —N(R′″)—, and —S—, and each R′″ is the same of different andrepresents hydrogen or (C₁-C₄)alkyl.

In one embodiment, R₆ is hydrogen.

In one embodiment, Pr¹ and Pr² are the same or different and areselected from hydrogen and a protecting group selected from a benzylgroup which is optionally substituted by (C₁-C₆)alkoxy, (C₁-C₆)acyloxy,hydroxy, nitro, picolyl, picolyl-N-oxide, anthrylmethyl, diphenylmethyl,phenyl, t-butyl, adamanthyl, (C₁-C₆)acyloxymethyl, (C₁-C₆)alkoxymethyl,tetrahydropyranyl, benzylthiomethyl, phenylthiomethyl, thiazolidine,acetamidemethyl, benzamidomethyl, tertiary butoxycarbonyl (BOC), acetyland its derivatives, benzoyl and its derivatives, carbamoyl,phenylcarbamoyl, and (C₁-C₆)alkylcarbamoyl.

Various romidepsin derivatives of formula (V) and (V′) are disclosed inPCT application publication WO 2006/129105, published Dec. 7, 2006,which is incorporated herein by reference.

In one embodiment, a formulation of romidepsin is a liquid concentrateformulation for dilution. In some embodiments, provided are liquidformulations comprising one or more additional components. In some suchembodiments, additional components are selected from the groupconsisting of, for example, solubilizers, stabilizers, buffers, tonicitymodifiers, bulking agents, viscosity enhancers/reducers, surfactants,chelating agents, adjuvants, diluents, solvents, or other pharmaceuticaladditives.

In one embodiment, the additional component is a buffer. In oneembodiment, the buffer is a citrate buffer. In another embodiment, thebuffer is an acetate buffer.

Pharmaceutical Formulations

In one embodiment, provided herein are pharmaceutical formulations ofromidepsin. In one embodiment, the formulation is a liquid concentrateformulation. In one embodiment, the formulation is a liquid concentrateformulation for dilution. In one embodiment, a liquid concentrateformulation for dilution is formulated in a solvent or a solvent system.In one embodiment, the solvent system comprises a citrate buffer. Inanother embodiment, the solvent system comprises an acetate buffer. Inone embodiment, a romidepsin formulation is an injectable formulation.

In one embodiment, the romidepsin liquid concentrate for dilution isformulated in a solvent system. It was found that the solubility issuesfor developing a liquid IV formulation of romidepsin presented aproblem. Romidepsin is practically insoluble in water. Therefore,solvent based formulations were explored. Solubility of romidepsin wasstudied in the following solvents and solvent mixtures: glycerin:EtOH(1:1); PEG 300; PEG 400; Tween 80:EtOH (1:1); dimethylacetamide (DMA);SolutolHS15:EtOH (1:1); NMP; Water; EtOH:PEG 400 (1:1); EtOH;water(4:6); EtOH; EtOH:PG (80:20); EtOH:PG (60:40); EtOH:PG (40:60); EtOH:PG(20:80); PG; EtOH:PG (40:60)+10% water; EtOH:PG (40:60)+butylatedhydroxyanizole (BHA)/butylated hydroxytoluebe (BHT); and EtOH:PG(40:60)+ascorbic acid.

Solvents suitable for use in the formulations provided herein include,but are not limited to, propylene glycol (PG), ethanol (EtOH) and abuffer. In one embodiment, the buffer is a citrate buffer. In anotherembodiment, the buffer is an acetate buffer.

In one embodiment, the solvent system is a combination of 70% PG, 20%EtOH and 10% citrate buffer. In some embodiments, the solvent systemcomprises an organic acid, in particular a fatty acid. In a particularembodiment, the fatty acid is oleic acid. In one embodiment, the solventsystem comprises 0.05% oleic acid. In another embodiment, the solventsystem comprises 0.10% oleic acid. In yet another embodiment, thesolvent system comprises 0.025% oleic acid.

In one embodiment, the solvent system is a combination of 30% PG, 30%EtOH and 40% acetate buffer. In another embodiment, the solvent systemis a combination of 70% PG, 20% EtOH and 10% citrate buffer.

In one embodiment, a liquid concentrate formulation is diluted intonormal saline.

In one embodiment, the pharmaceutical formulations provided herein maybe formulated in various dosage forms for parenteral administration. Inone embodiment, the pharmaceutical formulation provided herein may beprovided in a unit-dosage form or multiple-dosage form. A unit-dosageform, as used herein, refers to a physically discrete unit suitable foradministration to human and animal subjects, and packaged individuallyas is known in the art. Each unit-dose contains a predetermined quantityof the active ingredient(s) sufficient to produce the desiredtherapeutic effect, in association with the required pharmaceuticalcarriers or excipients. Examples of a unit-dosage form include anampoule, a vial, a prefilled syringe, a cartridge, or an IV bag. Aunit-dosage form may be administered in fractions or multiples thereof.A multiple-dosage form is a plurality of identical unit-dosage formspackaged in a single container to be administered in segregatedunit-dosage form. Examples of a multiple-dosage form include a vial.

In one embodiment, the pharmaceutical formulations provided herein maybe administered at once or multiple times at intervals of time. It isunderstood that the precise dosage and duration of treatment may varywith the age, weight, and condition of the patient being treated, andmay be determined empirically using known testing protocols or byextrapolation from in vivo or in vitro test or diagnostic data. It isfurther understood that for any particular individual, specific dosageregimens should be adjusted over time according to the individual needand the professional judgment of the person administering or supervisingthe administration of the formulations.

Parenteral Administration

In one embodiment, the pharmaceutical formulations provided herein maybe administered parenterally by injection or infusion, for local orsystemic administration. Parenteral administration, as used herein,include intravenous, intra-arterial, intraperitoneal, intrathecal,intraventricular, intraurethral, intrasternal, intracranial,intramuscular, intrasynovial, and subcutaneous administration.

In one embodiment, the pharmaceutical formulations provided herein maybe formulated in any dosage forms that are suitable for parenteraladministration, including solutions, suspensions, emulsions, micelles,liposomes, microspheres, nanosystems, and solid forms suitable forsolutions or suspensions in liquid prior to injection. Such dosage formscan be prepared according to conventional methods known to those skilledin the art of pharmaceutical science (see, e.g., Remington, The Scienceand Practice of Pharmacy, supra).

In one embodiment, the pharmaceutical formulations intended forparenteral administration may include one or more pharmaceuticallyacceptable carriers and excipients, including, but are not limited to,aqueous vehicles, water-miscible vehicles, non-aqueous vehicles,antimicrobial agents or preservatives against the growth ofmicroorganisms, stabilizers, solubility enhancers, isotonic agents,buffering agents, antioxidants, local anesthetics, suspending anddispersing agents, wetting or emulsifying agents, complexing agents,sequestering or chelating agents, cryoprotectants, lyoprotectants,thickening agents, pH adjusting agents, and inert gases.

In one embodiment, suitable aqueous vehicles include, but are notlimited to, water, saline, physiological saline or phosphate bufferedsaline (PBS), citrate buffer, acetate buffer, sodium chloride injection,Ringers injection, isotonic dextrose injection, sterile water injection,dextrose and lactated Ringers injection.

Non-aqueous vehicles include, but are not limited to, fixed oils ofvegetable origin, castor oil, corn oil, cottonseed oil, olive oil,peanut oil, peppermint oil, safflower oil, sesame oil, soybean oil,hydrogenated vegetable oils, hydrogenated soybean oil, and medium-chaintriglycerides of coconut oil, and palm seed oil.

Water-miscible vehicles include, but are not limited to, ethanol,1,3-butanediol, liquid polyethylene glycol (e.g., polyethylene glycol300 and polyethylene glycol 400), propylene glycol, glycerin,N-methyl-2-pyrrolidone, N,N-dimethylacetamide, and dimethyl sulfoxide.

In one embodiment, suitable antimicrobial agents or preservativesinclude, but are not limited to, phenols, cresols, mercurials, benzylalcohol, chlorobutanol, methyl and propyl p-hydroxybenzoates,thimerosal, benzalkonium chloride (e.g., benzethonium chloride), methyl-and propyl-parabens, and sorbic acid.

Suitable isotonic agents include, but are not limited to, sodiumchloride, glycerin, and dextrose.

Suitable buffering agents include, but are not limited to, phosphate,acetate and citrate.

Suitable antioxidants include, but are not limited to, bisulfate andsodium metabisulfite.

Suitable local anesthetics include, but are not limited to, procainehydrochloride.

Suitable suspending and dispersing agents include, but are not limitedto, sodium carboxymethylcelluose, hydroxypropyl methylcellulose, andpolyvinylpyrrolidone.

Suitable emulsifying agents include, but are not limited to,polyoxyethylene sorbitan monolaurate, polyoxyethylene sorbitanmonooleate 80, and triethanolamine oleate.

Suitable sequestering or chelating agents include, but are not limitedto, EDTA.

Suitable pH adjusting agents include, but are not limited to, sodiumhydroxide, hydrochloric acid, acetic acid, citric acid, lactic acid, andsodium citrate.

Suitable complexing agents include, but are not limited to,cyclodextrins, including α-cyclodextrin, β-cyclodextrin,hydroxypropyl-β-cyclodextrin, sulfobutylether-β-cyclodextrin, andsulfobutylether 7-β-cyclodextrin (CAPTISOL®, CyDex, Lenexa, Kans.).

In one embodiment, a vehicle suitable for a liquid concentrateromidepsin formulation is propylene glycol (70): ethanol (20): citratebuffer (10) (pH-3.0; 25 mM). In one embodiment, a vehicle suitable for aliquid concentrate romidepsin formulation is propylene glycol (70):ethanol (20): acetate buffer (10) (pH-3.0; 25 mM).

In one embodiment, the pharmaceutical formulations provided herein areformulated for single or multiple dosage administration. In oneembodiment, the single dosage formulations are packaged in an ampoule, avial, or a syringe. In one embodiment, the multiple dosage formulationsare packaged in a vial. In one embodiment, the multiple dosageparenteral formulations contain an antimicrobial agent at bacteriostaticor fungistatic concentrations. All parenteral formulations are sterile,as known and practiced in the art.

In one embodiment, the pharmaceutical formulations are provided asready-to-use sterile solutions. In another embodiment, thepharmaceutical formulations are provided as sterile dry solubleproducts, including lyophilized powders to be reconstituted with avehicle prior to use.

Combination Therapy

In some embodiments, romidepsin is administered in combination with oneor more other pharmaceutical agents. In some embodiments, romidepsin isadministered in combination with one or more other chemotherapeuticagents and/or in combination with one or more other pharmaceuticalagents (e.g., pain relievers, anti-inflammatories, antibiotics,steroidal agents, anti-folates, kinase inhibitors, methyl transferaseinhibitors, antibodies, etc.).

In certain embodiments, romidepsin is administered in combination withone or more cytotoxic agents. Exemplary cytotoxic agents include, butare not limited to, gemcitabine, decitabine, and flavopiridol. Incertain embodiments, romidepsin is administered in combination with oneor more taxanes and/or one or more proteasome inhibitors. Exemplaryproteasome inhibitors include, but are not limited to, bortezomib(VELCADE®), peptide boronates, salinosporamide A (NPI-0052),lactacystin, epoxomicin (Ac(Me)-Ile-Ile-Thr-Leu-EX), MG-132(Z-Leu-Leu-Leu-al), PR-171, PS-519, eponemycin, aclacinomycin A,CEP-1612, CVT-63417, PS-341 (pyrazylcarbonyl-Phe-Leu-boronate), PSI(Z-Ile-Glu(OtBu)-Ala-Leu-al), MG-262 (Z-Leu-Leu-Leu-bor), PS-273 (MNLB),omuralide (clasto-lactacystin-β-lactone), NLVS (Nip-Leu-Leu-Leu-vinylsulfone), YLVS (Tyr-Leu-Leu-Leu-vs), dihydroeponemycin, DFLB(dansyl-Phe-Leu-boronate), ALLN (Ac-Leu-Leu-Nle-al),3,4-dichloroisocoumarin, 4-(2-aminoethyl)-benzenesulfonyl fluoride,TMC-95A, gliotoxin, EGCG ((-)-epigallocatechin-3-gallate), YU101(Ac-hFLFL-ex), and combinations thereof.

In certain embodiments, romidepsin is administered in combination withone or more anti-folates. In some such embodiments, romidepsin isadministered in combination with one or more of: folinic acid(leucovorin), methotrexate, pralatrexate, premextred, triazinate, orcombinations thereof.

In certain embodiments, romidepsin is administered in combination withone or more kinase inhibitors (e.g., tyrosine kinase inhibitors). Insome embodiments, romidepsin is administered in combination with one ormore antibodies that act as a kinase inhibitor. In some embodiments,romidepsin is administered in combination with one or more of ABT-869,AC220, AZD7762, BIBW 2992, BMS-690154, CDKIAT7519, CYC116, ISIS3521,GSK690693, GSK-461364, MK-0457, MLN8054, MLN8237, MP470, ON 01910.Na ,OSI-930, PHA-739358, R935788, SNS-314, TLN-232, XL147, XL228, XL281,XL418, or XL765.

In certain embodiments, romidepsin is administered in combination withone or more methyl transferase inhibitors.

In certain embodiments, romidepsin is administered in combination withone or more therapeutic antibodies. In some embodiments, the therapeuticantibodies include, but are not limited to, bevacizumab, cetuximab,dasatinib, erlotinib, geftinib, imatinib, lapatinib, nilotinib,panitumumab, pegaptanib, ranibizumab, sorafenib, sunitinib, trastuzumab,or any antibody that binds to an antigen bound by one of these moieties.

In some embodiments, romidepsin is administered in combination with ananti-inflammatory agent, pain reliever, anti-nausea medication, oranti-pyretic. Anti-inflammatory agents useful in the methods providedherein include, but are not limited to, aspirin, ibuprofen, andacetaminophen.

In certain embodiments, romidepsin is administered in combination with asteroidal agent. In certain embodiments, romidepsin is administered incombination with a steroidal agent selected from the group consisting ofalclometasone diproprionate, amcinonide, beclomethasone diproprionate,betamethasone, betamethasone benzoate, betamethasone diproprionate,betamethasone sodium phosphate, betamethasone sodium phosphate andacetate, betamethasone valerate, clobetasol proprionate, clocortolonepivalate, cortisol (hydrocortisone), cortisol (hydrocortisone) acetate,cortisol (hydrocortisone) butyrate, cortisol (hydrocortisone) cypionate,cortisol (hydrocortisone) sodium phosphate, cortisol (hydrocortisone)sodium succinate, cortisol (hydrocortisone) valerate, cortisone acetate,desonide, desoximetasone, dexamethasone, dexamethasone acetate,dexamethasone sodium phosphate, diflorasone diacetate, fludrocortisoneacetate, flunisolide, fluocinolone acetonide, fluocinonide,fluorometholone, flurandrenolide, halcinonide, medrysone,methylprednisolone, methylprednisolone acetate, methylprednisolonesodium succinate, mometasone furoate, paramethasone acetate,prednisolone, prednisolone acetate, prednisolone sodium phosphate,prednisolone tebutate, prednisone, triamcinolone, triamcinoloneacetonide, triamcinolone diacetate, triamcinolone hexacetonide, orcombinations thereof. In one embodiment, romidepsin is administered incombination with dexamethasone.

In certain embodiments, romidepsin is administered in combination withan agent to treat gastrointestinal disturbances such as nausea,vomiting, and diarrhea. Such agents include, but are not limited to,anti-emetics, anti-diarrheals, fluid replacements, electrolytereplacements, etc.

In certain embodiments, romidepsin is administered in combination withelectrolyte replacement or supplementation such as potassium, magnesium,or calcium. In certain embodiments, romidepsin is administered incombination with electrolyte replacement or supplementation such aspotassium, and/or magnesium.

In certain embodiments, romidepsin is administered in combination withan anti-arrhythmic agent.

In certain embodiments, romidepsin is administered in combination withan agent that increases the production of platelets.

In certain embodiments, romidepsin is administered in combination withan agent to boost the production of blood cells. In certain embodiments,the agent is erythropoietin.

In some embodiments, romidepsin is administered in combination with anagent to prevent hyperglycemia.

In certain embodiments, romidepsin is administered with another HDAC orDAC inhibitor.

Methods Of Use

In one embodiment, provided is a method for treating, preventing, ormanaging cancer in a patient comprising administering to said patient aneffective amount of a liquid concentrate formulation provided herein.

In some embodiments, cancers treatable by the methods provided hereininclude, but are not limited to, carcinomas, sarcomas, haematologicalmalignancies and the like. In certain embodiments, cancer is ahematological malignancy. In certain embodiments, cancer is a solidtumor.

In one embodiment, hematological malignancies that can be treated by themethods provided herein include, but are not limited to, lymphomas,leukemias, multiple myeloma, plasma cell-derived cancers, relapsedhematological malignancies, and refractory hematological malignancies.In one embodiment, lymphomas that can be treated by the methods providedherein include, but are not limited to, mature B-cell lymphomas, matureT-cell and natural killer cell lymphomas, Hodgkin's lymphomas andimmunodeficiency-associated lymphoproliferative disorders. In anotherembodiment, lymphomas that can be treated by the methods provided hereininclude, but are not limited to, small lymphocytic lymphoma, follicularlymphoma, Mantle cell lymphoma, diffuse large B-cell lymphoma, Burkittlymphoma, B-cell lymphoblastic lymphoma, small cleaved B-cell lymphoma,non-cleaved B-cell lymphoma, cutaneous T-cell lymphoma (CTCL), andperipheral T-cell lymphoma (PTCL). In another embodiment, leukemias thatcan be treated by the methods provided herein include, but are notlimited to, acute lymphoid leukemia (ALL), chronic lymphocytic leukemia(CLL), acute myeloid leukemia (AML), chronic myeloid leukemia (CIVIL),MLL-rearranged ALL, including leukemias that are relapsed, refractory orresistant to conventional therapy, multiple myeloma, and plasmacell-derived cancer.

In one embodiment, solid cancers that can be treated by the methodsprovided herein include, but are not limited to, cancer of the skin;lymph node; breast; cervix; uterus; gastrointestinal tract; pancreas,lung; ovary; prostate; colon; rectal; mouth; brain; head and neck;throat; testes; kidney; pancreas; bone; spleen; liver; bladder; larynx;or nasal passages, and relapsed or refractory cancer.

In one embodiment, an effective amount of romidepsin to be used is atherapeutically effective amount. In one embodiment, the amounts ofromidepsin to be used in the methods provided herein include an amountsufficient to cause improvement in at least a subset of patients withrespect to symptoms, overall course of disease, or other parametersknown in the art. Precise amounts for therapeutically effective amountsof romidepsin in the pharmaceutical compositions will vary depending onthe age, weight, disease, and condition of the patient.

In one embodiment, romidepsin is administered intravenously. In oneembodiment, romidepsin is administered intravenously over a 1-6 hourperiod. In one embodiment, romidepsin is administered intravenously overa 3-4 hour period. In one embodiment, romidepsin is administeredintravenously over a 5-6 hour period. In one embodiment, romidepsin isadministered intravenously over a 4 hour period.

In one embodiment, romidepsin is administered in a dose ranging from 0.5mg/m² to 28 mg/m². In one embodiment, romidepsin is administered in adose ranging from 0.5 mg/m² to 5 mg/m². In one embodiment, romidepsin isadministered in a dose ranging from 1 mg/m² to 25 mg/m². In oneembodiment, romidepsin is administered in a dose ranging from 1 mg/m² to20 mg/m². In one embodiment, romidepsin is administered in a doseranging from 1 mg/m² to 15 mg/m². In one embodiment, romidepsin isadministered in a dose ranging from 2 mg/m² to 15 mg/m². In oneembodiment, romidepsin is administered in a dose ranging from 2 mg/m² to12 mg/m². In one embodiment, romidepsin is administered in a doseranging from 4 mg/m² to 12 mg/m². In one embodiment, romidepsin isadministered in a dose ranging from 6 mg/m² to 12 mg/m². In oneembodiment, romidepsin is administered in a dose ranging from 8 mg/m² to12 mg/m². In one embodiment, romidepsin is administered in a doseranging from 8 mg/m² to 10 mg/m². In one embodiment, romidepsin isadministered in a dose of about 8 mg/m². In one embodiment, romidepsinis administered in a dose of about 9 mg/m². In one embodiment,romidepsin is administered in a dose of about 10 mg/m². In oneembodiment, romidepsin is administered in a dose of about 11 mg/m². Inone embodiment, romidepsin is administered in a dose of about 12 mg/m².In one embodiment, romidepsin is administered in a dose of about 13mg/m². In one embodiment, romidepsin is administered in a dose of about14 mg/m². In one embodiment, romidepsin is administered in a dose ofabout 15 mg/m².

In one embodiment, romidepsin is administered in a dose of 14 mg/m² overa 4 hour iv infusion on days 1, 8 and 15 of the 28 day cycle. In oneembodiment, the cycle is repeated every 28 days.

In one embodiment, increasing doses of romidepsin are administered overthe course of a cycle. In one embodiment, the dose of about 8 mg/m²followed by a dose of about 10 mg/m², followed by a dose of about 12mg/m² is administered over a cycle.

In some embodiments, unit doses of romidepsin are within the range ofabout 0.5 mg/m² to about 28 mg/m². In certain embodiments, unit dosesare in the range of about 1 mg/m² to about 25 mg/m². In certainembodiments, unit doses are in the range of about 0.5 mg/m² to about 15mg/m². In certain embodiments, unit doses are the range of about 1 mg/m²to about 15 mg/m². In certain embodiments, unit doses are in the rangeof about 1 mg/m² to about 8 mg/m². In certain embodiments, unit dosesare in the range of about 0.5 mg/m² to about 5 mg/m². In certainembodiments, the unit doses are in the range of about 2 mg/m² to about10 mg/m². In some embodiments, unit doses are in the range of about 10mg/m² to about 20 mg/m². In certain embodiments, unit doses are in therange of about 5 mg/m² to about 10 mg/m². In some embodiments, unitdoses are in the range of about 10 mg/m² to about 15 mg/m². In someembodiments, unit doses are in the range of about 6 to about 19 mg/m².In some embodiments, unit doses are approximately 8 mg/m². In stillother embodiments, the unit doses are approximately 9 mg/m². In stillother embodiments, unit doses are approximately 10 mg/m². In still otherembodiments, unit doses are approximately 11 mg/m². In still otherembodiments, unit doses are approximately 12 mg/m². In still otherembodiments, unit doses are approximately 13 mg/m². In still otherembodiments, unit doses are approximately 14 mg/m². In still otherembodiments, unit doses are approximately 15 mg/m². In still otherembodiments, unit doses are approximately 30 mg/m².

In certain embodiments, different individual unit doses within theromidepsin therapy regimen are different. In some embodiments,increasing doses of romidepsin are administered over the course of acycle. In certain embodiments, a dose of approximately 8 mg/m² isadministered, followed by a dose of approximately 10 mg/m², followed bya dose of approximately 12 mg/m² may be administered over a cycle.

An amount of romidepsin administered in individual unit doses variesdepending on the form of romidepsin being administered. In certainembodiments, individual unit doses of romidepsin are administered on oneday followed by several days on which romidepsin is not administered. Incertain embodiments, romidepsin is administered twice a week. In certainembodiments, romidepsin is administered once a week. In otherembodiments, romidepsin is administered every other week.

In some embodiments, romidepsin is administered daily (for example for 2weeks), twice weekly (for example for 4 weeks), thrice weekly (forexample for 4 weeks), or on any of a variety of other intermittentschedules (e.g., on days 1, 3, and 5; on days 4 and 10; on days 1 and15; on days 5 and 12; or on days 5, 12, and 19 of 21 or 28 day cycles).

In certain embodiments, romidepsin is administered on days 1, 8, and 15of a 28 day cycle. In certain particular embodiments, an 8 mg/m² dose ofromidepsin is administered on day 1, a 10 mg/m² dose of romidepsin isadministered on day 8, and a 12 mg/m² dose of romidepsin is administeredon day 15. In certain embodiments, romidepsin is administered on days 1and 15 of a 28 day cycle with day 8 being skipped. A 28 day dosing cyclemay be repeated. In certain embodiments, a 28 day cycle is repeated2-10, 2-7, 2-5, or 3-10 times. In certain embodiments, the treatmentincludes 5 cycles. In certain embodiments, the treatment includes 6cycles. In certain embodiments, the treatment includes 7 cycles. Incertain embodiments, the treatment includes 8 cycles. In certainembodiments, 10 cycles are administered. In certain embodiments, greaterthan 10 cycles are administered.

Dosing

In some embodiments, romidepsin and/or compositions comprisingromidepsin are administered according to a standard dosing regimen. Insome embodiments, romidepsin and/or compositions comprising romidepsinare administered according to an accelerated dosing regimen.

Standard Dosing for Romidepsin

In some embodiments, unit doses of romidepsin are within the range ofabout 0.5 mg/m² to about 28 mg/m² body surface area. In someembodiments, the range of about 6 to about 18 mg/m² is used. In someembodiments, the range is about 10 mg/m² to about 17 mg/m². In someembodiments, particular unit doses are 10 mg/m^(2,) 12 mg/m^(2,) 13mg/m^(2,) 14 mg/m², and 15 mg/m².

In some embodiments, intravenous dosing regimens include daily dosingfor 2 weeks, twice weekly dosing for 4 weeks, thrice weekly dosing for 4weeks, and various other intermittent schedules (e.g., on days 1, 3, and5; on days 4 and 10; on days 1, 8 and 15; on days 1 and 15; on days 5and 12; or on days 5, 12, and 19 of 21 or 28 day cycles).

In some embodiments, romidepsin is administered in individual unit dosesover 4 hours on days 1, 8, and 15, with courses repeating every 28 days.Often, several courses (e.g., at least 4, at least 6, or more) areadministered. Indeed, instances have been reported of as many as 72courses being administered. In some embodiments, individual unit dosesare administered by 4 hour infusion.

Accelerated Dosing for Romidepsin

Accelerated dosing regimens for romidepsin may be utilized, in which oneor more individual unit doses is administered intravenously over aperiod of time that is less than or equal to about one hour. In someembodiments, one or more individual doses are administered intravenouslyover a period of time that is less than about 50 minutes, 40 minutes, 30minutes, 20 minutes, or less. Any regimen that includes at least oneunit dose administered over a period of time that is less than about onehour (60 minutes) may be considered an accelerated dosing regimen inaccordance with the present disclosure.

In some embodiments, all unit doses within a regimen are administeredintravenously over a time period that is less than or equal to about onehour. In some embodiments, only some of the unit doses within a regimenare administered over a time period that is less than or equal to aboutone hour. In some embodiments, one or more unit doses within a regimenare administered by a route other than intravenous administration (e.g.,oral, subcutaneous, nasal, topical, etc.).

Accelerated dosing regimens of romidepsin can be administered without asignificant increase in toxicity or adverse events, particularly inserious adverse events, as compared with a comparable regimen (e.g., anotherwise identical regimen) in which individual unit doses areadministered intravenously over a 4-hour period. In one embodiment,accelerated dosing regimens can be administered without a significantincrease in toxicity or adverse events, particularly in serious adverseevents, as compared with a standard regimen of romidepsin administeredby 4-hour intravenous infusion of a dose of about 6-14 mg/m² on days 1,8, and 15 of a 28 day cycle.

In some embodiments, romidepsin is administered in an accelerated dosingregimen that is identical to a standard dosing regimen except that oneor more unit doses is administered over a time period that is less thanabout 1 hour (e.g., rather than over a time period of about 4 hours).

As will be appreciated by one of skill in the art, the dosage, timingand/or routes of administration of particular unit doses of romidepsinmay vary depending on the patient and condition being treated. Incertain embodiments, the cycles are continued as long as the patient isresponding. Therapy may be terminated once there is disease progression,a cure or remission is achieved, or side effects become intolerable.Adverse side effects may also call for lowering the dosage of romidepsinadministered, or for adjusting the schedule by which doses areadministered.

Kits

In one embodiment, a kit comprises a dosage form of romidepsin liquidconcentrate formulation for dilution. Kits can further comprise apharmacologically active derivative of romidepsin.

In other embodiments, kits can further comprise devices that are used toadminister the active ingredients. Examples of such devices include, butare not limited to, syringes, and drip bags.

In one embodiment, kits can further comprise a pharmaceuticallyacceptable vehicle that can be used to administer one or more activeingredients. For example, if an active ingredient is provided as steriledry soluble products, including lyophilized powders to be reconstitutedwith a vehicle prior to use, the kit can comprise a sealed container ofa suitable vehicle in which the active ingredient can be reconstitutedto form a particulate-free sterile solution that is suitable forparenteral administration. Examples of pharmaceutically acceptablevehicles include, but are not limited to: Water for Injection USP;aqueous vehicles such as, but not limited to, Sodium Chloride Injection,Ringer's Injection, Dextrose Injection, Dextrose and Sodium ChlorideInjection, and Lactated Ringer's Injection; water-miscible vehicles suchas, but not limited to, ethyl alcohol, polyethylene glycol, andpolypropylene glycol; and non-aqueous vehicles such as, but not limitedto, corn oil, cottonseed oil, peanut oil, sesame oil, ethyl oleate,isopropyl myristate, and benzyl benzoate.

Unless otherwise defined, all technical and scientific terms used hereinare accorded the meaning commonly known to one of skill in the art. Allpublications, patents, published patent applications, and otherreferences mentioned herein are hereby incorporated by reference intheir entirety. The embodiments of the disclosure should not be deemedto be mutually exclusive and can be combined.

EXAMPLES

The following examples are provided by way of illustration, notlimitation.

Example 1 Romidepsin Liquid Concentrate Injectable Formulations

Romidepsin liquid concentrate injectable formulation (citrate buffer)and romidepsin liquid concentrate injectable formulation (acetatebuffer) were manufactured at the Celgene, Melrose Park, Ill. PilotLaboratory using romidepsin raw material (Manufacturer: Sandoz). Theproduct information for the two formulations is summarized in Table 1(Citrate Buffer) and Table 2 (Acetate Buffer).

TABLE 1 Product name Romidepsin Injection (Citrate Buffer) Strength 5 mgRomidepsin/mL Banch Size 1 L Vehicle Propylene Glycol:Ethanol:Citratebuffer (pH 4.5, 25 mM) = 70:20:10 Fill Volume 2 mL Claim Container andVials, Schott, P.O. # BL-026545, Closure Item # 5010-2095, Lot #6102291228; Stoppers, Westar RS, 13 mm Teflon 4416/50; Grey; Caps 13 mm,light blue RM (active) Romidepsin Excipient Propylene Glycol, Ethanol,Citric Acid Anhydrous, Sodium Citrate Dihydrate

TABLE 2 Product name Romidepsin Injection (Acetate Buffer) Strength 5 mgRomidepsin/mL Banch Size 1 L Vehicle Propylene Glycol:Ethanol:Acetatebuffer (pH 4.0, 25 mM) = 30:30:40 Fill Volume 2 mL Claim Container andVials, Schott, P.O. # BL-026545, Closure Item # 5010-2095, Lot #6102291228; Stoppers, Westar RS, 13 mm Teflon 4416/50; Grey; Caps 13 mm,light blue RM (active) Romidepsin Excipient Propylene Glycol, Ethanol,Acetic Acid Glacial

Example 2 Stability of Romidepsin Liquid Concentrate InjectableFormulations

Storage Conditions

Finished romidepsin liquid concentrate injectable formulation (citratebuffer) and romidepsin liquid concentrate injectable formulation(acetate buffer) were injected in vials and stored inverted and uprightper stability testing protocols in storage chambers maintained at −85°C. to −70° C. and −25° C. to −10° C., 5° C.±3° C., 25° C.±2° C./60%RH±5% RH, and 40° C.±2° C./75% RH±5% RH. A pre-determined number ofvials was removed from storage after specified time periods for tersing.

Test Methods

The testing parameters included: visual appearance/color of solution,pH, romidepsin assay, individual impurities, and total impurities byHPLC.

Results

Based on formulation composition design of experiment study of thepotentially promising compositions, five formulations were selected. Theromidepsin liquid concentrate formulations were prepared at 100 mL batchsize. Two mL aliquots of each formulation were filled into 2 mL clearampoule vials and sealed. The compositions of romidepsin liquidconcentrate injectable formulations are listed in Table 3.

TABLE 3 Formu- Romidepsin 5 mg/mL lation 1 PG:EtOH:citrate buffer (pH4.5; 25 mM)::70:20:10 with 0.05% oleic acid Formu- Romidepsin 5 mg/mLlation 2 PG:EtOH:citrate buffer (pH 4.5; 25 mM)::70:20:10 Formu-Romidepsin 5 mg/mL lation 3 PG:EtOH:citrate buffer (pH 4.5; 50mM)::70:20:10 with 0.10% oleic acid Formu- Romidepsin 5 mg/mL lation 4PG:EtOH:acetate buffer (pH 4.0; 20 mM)::30:30:40 Formu- Romidepsin 5mg/mL lation 5 PG:EtOH:citrate buffer (pH 4.5; 25 mM)::70:20:10 with0.025% oleic acid

Table 4 shows the stability data of five romidepsin liquid concentrateinjectable formulations stored at 5° C.

TABLE 4 Samples stored at 5° C. LC Relative peak area @ RRT (%) 0.340.45 1.00 1.36 1.89 2.04 2.85 F1-1 initial 102.2 100.00 1 M 102.1 100.002 M 102.2 100.00 3 M 103.1 100.00 6 M 104.0 100.00 F1-2 initial 103.8100.00 1 M 102.4 100.00 2 M 103.1 100.00 3 M 103.1 100.00 6 M 105.3100.00 F2-1 initial 104.7 100.00 1 M 104.1 100.00 2 M 102.8 100.00 3 M104.4 100.00 6 M 105.0 100.00 F2-2 initial 104.7 100.00 1 M 103.9 100.002 M 103.6 100.00 3 M 104.7 100.00 6 M 106.1 100.00 F3-1 initial 104.3100.00 1 M 102.7 100.00 2 M 103.1 100.00 3 M 103.4 100.00 6 M 104.1100.00 F3-2 initial 103.2 100.00 1 M 103.2 100.00 2 M 102.6 100.00 3 M103.6 100.00 6 M 104.4 100.00 F4-1 initial 108.3 100.00 1 M 107.1 100.002 M 106.5 100.00 3 M 108.3 100.00 6 M 108.2 100.00 F4-2 initial 108.4100.00 1 M 107.0 100.00 2 M 106.5 100.00 3 M 107.7 100.00 6 M 108.4100.00 F5-1 initial 101.7 100.00 1 M 102.2 100.00 2 M 102.4 100.00 3 M103.2 100.00 6 M 103.6 100.00 F5-2 initial 102.7 100.00 1 M 102.4 100.002 M 102.1 100.00 3 M 103.6 100.00 6 M 103.7 100.00

Table 5 shows the stability data of five romidepsin liquid concentrateinjectable formulations stored at controlled ambient temperature.

TABLE 5 Samples stored at RT LC Relative peak area @ RRT (%) 0.34 0.451.00 1.36 1.89 2.04 2.85 F1-1 initial 102.2 100.00 1 M 103.8 100.00 2 M103.9 100.00 3 M 104.2 100.00 6 M 105.7 100.00 F1-2 initial 103.8 100.001 M 102.8 100.00 2 M 104.3 100.00 3 M 102.7 100.00 6 M 106.3 100.00 F2-1initial 104.7 100.00 1 M 103.5 100.00 2 M 104.3 100.00 3 M 104.1 100.006 M 107.4 100.00 F2-2 initial 104.7 100.00 1 M 103.6 100.00 2 M 104.0100.00 3 M 103.8 100.00 6 M 106.0 100.00 F3-1 initial 104.3 100.00 1 M103.6 100.00 2 M 103.4 100.00 3 M 103.9 100.00 6 M 104.6 100.00 F3-2initial 103.2 100.00 1 M 104.1 100.00 2 M 103.6 100.00 3 M 103.8 100.006 M 105.6 100.00 F4-1 initial 108.3 100.00 1 M 108.2 100.00 2 M 107.9100.00 3 M 108.0 100.00 6 M 110.0 100.00 F4-2 initial 108.4 100.00 1 M107.4 100.00 2 M 108.1 100.00 3 M 107.9 100.00 6 M 109.1 100.00 F5-1initial 101.7 100.00 1 M 103.2 100.00 2 M 103.0 100.00 3 M 103.4 100.006 M 104.9 100.00 F5-2 initial 102.7 100.00 1 M 103.3 100.00 2 M 103.0100.00 3 M 103.4 100.00 6 M 104.3 100.00

Table 6 shows the stability data of five romidepsin liquid concentrateinjectable formulations stored at 40° C.

TABLE 6 Samples stored at 40° C. Relative peak area @ RRT LC 0.34 0.370.45 0.53 0.60 0.67 1.00 1.36 1.89 2.04 2.85 F1-1 initial 102.2 100.00 1M 102.8 100.00 2 M 103.0 99.84 0.07 0.09 3 M 106.6 0.06 0.04 99.76 0.040.09 6 M 102.2 0.13 0.03 0.09 0.04 99.40 0.09 0.22 F1-2 initial 103.8100.00 1 M 103.0 100.00 2 M 110.4 99.91 0.04 0.06 3 M 103.3 0.03 0.0399.78 0.06 0.10 6 M 113.2 0.28 0.05 0.19 0.07 0.09 99.03 0.06 0.20 F2-1initial 104.7 100.00 1 M 103.5 100.00 2 M 103.5 99.91 0.04 0.05 3 M103.6 0.04 0.03 99.79 0.05 0.10 6 M 103.0 0.15 0.05 0.09 0.03 0.05 99.330.09 0.21 F2-2 initial 104.7 100.00 1 M 103.1 100.00 2 M 105.9 99.890.04 0.07 3 M 103.4 0.04 0.03 99.78 0.06 0.10 6 M 103.9 0.13 0.03 0.080.03 99.43 0.09 0.20 F3-1 initial 104.3 100.00 1 M 102.3 100.00 2 M102.3 99.95 0.05 3 M 103.2 0.04 0.03 99.82 0.04 0.07 6 M 102.5 0.15 0.050.09 0.03 0.05 99.39 0.07 0.18 F3-2 initial 103.2 100.00 1 M 102.9100.00 2 M 103.4 99.92 0.04 0.04 3 M 103.0 0.03 0.04 99.81 0.04 0.07 6 M102.6 0.15 0.05 0.10 0.05 99.37 0.08 0.18 F4-1 initial 108.3 100.00 1 M106.9 100.00 2 M 109.7 99.90 0.04 0.05 3 M 107.7 99.84 0.08 0.08 6 M108.3 0.04 99.64 0.16 0.16 F4-2 initial 108.4 100.00 1 M 107.2 100.00 2M 108.6 99.90 0.05 0.05 3 M 107.4 99.88 0.07 0.05 6 M 107.6 0.03 99.680.14 0.15 F5-1 initial 101.7 100.00 1 M 102.9 100.00 2 M 103.9 99.950.05 3 M 102.1 0.03 0.03 99.81 0.05 0.08 6 M 101.0 0.18 0.11 0.04 0.0799.34 0.08 0.19 F5-2 initial 102.7 100.00 1 M 103.0 100.00 2 M 104.399.89 0.04 0.07 3 M 102.4 0.03 99.83 0.06 0.08 6 M 101.6 0.16 0.05 0.110.03 0.07 99.32 0.08 0.19

Table 7 shows the stability data of romidepsin liquid concentrateinjectable formulations after exposure to light.

TABLE 7 Stressed at RT under light LC Relative peak area @ RRT (%) 0.340.45 1.00 1.36 1.89 2.04 2.85 F1 initial 102.2 100.00 1 M 102.4 100.0 2M 101.7 99.85 0.05 0.10 3 M 102.4 99.70 0.03 0.08 0.03 0.14 6 M 101.799.73 0.09 0.18 F2 initial 104.7 100.0 1 M 102.8 100.0 2 M 102.1 99.820.07 0.12 3 M 103.4 99.66 0.02 0.11 0.02 0.18 6 M 102.0 99.50 0.03 0.170.29 F3 initial 104.3 100.0 1 M 103.2 100.0 2 M 101.7 99.83 0.06 012 3 M102.9 99.76 0.02 0.07 0.02 0.13 6 M 102.1 99.78 0.07 0.14 F4 initial108.3 100.0 1 M 106.7 99.95 0.05 2 M 105.4 99.64 0.16 0.20 3 M 107.099.57 0.04 0.17 0.02 0.20 6 M 104.8 99.35 0.06 0.27 0.33 F5 initial101.7 100.0 1 M 102.3 100.0 2 M 101.7 99.83 0.06 0.11 3 M 102.4 99.630.04 0.12 0.02 0.20 6 M 100.8 99.55 0.15 0.30

No loss of potency was observed for all tested formulations over thestability test period as demonstrated by the consistency of the % labelclaim results. Individual related substances were found to be less than0.05% or not detected at all time points up to 6 months at 5° C. andcontrolled ambient conditions. A few related substances were observedwith the stability samples under accelerated conditions at 40° C. Thehighest level of related substance observed was no more than 0.30% at 6months at 40° C. Samples exposed to light showed higher levels ofrelated substances when compoared with samples stores in dark atcontrolled ambient temperature.

Dilution study was performed to evaluate the compatibility of the testedformulations with normal saline. A dose of 22.5 mg (4.5 mL offormulation) was diluted into 250 mL of normal saline. After gentlemixing, the diluted formulation was observed for appearance.Formulations with oleic acid as a component (formulations 1, 3 and 5)showed haziness in the diluted samples while formulations without oleicacid (formulations 2 and 4) appeared clear. These results indicate thatthe romidepsin liquid concentrate injectable formulations 2 and 4 arecompatible with normal saline upon dilution and were used for furtherstudies.

Summary of stability test results for romidepsin liquid concentrateinjection in citrate buffer (formulation 2) and romidepsin liquidconcentrate injection in acetate buffer (formulation 4) are shown inTables 8-15.

Tables 8 and 9 demonstrate test results for romidepsin liquidconcentrate injection in citrate buffer and romidepsin liquidconcentrate injection in acetate buffer stored at −85° C. to −70° C. andat −25° C. to −10° C. up to 1 month, accordingly.

TABLE 8 Citrate Acetate Upright Inverted Upright Inverted n = 2 0 1 W 1M 0 1 W 1 M 0 1 W 1 M 0 1 W 1 M Label Claim 103.5 104.1 104.8 103.5104.1 105.0 105.2 107.4 107.7 105.2 107.4 108.0 (%) Impurities 0.09 (%)Total 0.09 Impurities (%) Appearance Sample solution is transparent, novisible particulate matter pH 4.5 4.6 4.7 4.5 4.7 4.7 4.0 4.1 4.1 4.04.1 4.1

TABLE 9 Citrate Acetate Upright Inverted Upright Inverted n = 2 0 1 W 1M 0 1 W 1 M 0 1 W 1 M 0 1 W 1 M Label Claim 103.5 104.8 104.8 103.5101.7 104.1 105.2 107.5 108.2 105.2 107.9 107.7 (%) Impurities 0.09 (%)Total 0.09 Impurities (%) Appearance Sample solution is transparent, novisible particulate matter pH 4.5 4.7 4.7 4.5 4.7 4.7 4.0 4.1 4.2 4.04.1 4.2

Tables 10 and 11 show the test results for romidepsin liquid concentrateinjection in citrate buffer (Table 10) and romidepsin liquid concentrateinjection in acetate buffer (Table 11) stored at 5° C.±3° C. up to 12months.

TABLE 10 Citrate Upright Inverted n = 2 0 1 M 3 M 6 M 9 M 12 M 0 1 M 3 M6 M 9 M 12 M Label 103.5 105.0 NA 102.6 NA 104.7 103.5 105.7 105.7 103.5103.3 105.0 Claim (%) Impurities 0.09 0.09 NA 0.09 NA 0.09 0.09 0.090.09 0.10 0.09 0.10 (%)¹ Total 0.09 0.09 NA 0.09 NA 0.09 0.09 0.09 0.090.10 0.09 0.10 Impurities (%) Appearance Sample Sample NA Clear Samplesolution is Clear solution, solution is solution is solution,transparent, no visible no visible transparent, transparent, no visibleparticulate matter particulate no visible no visible particulate matterparticulate particulate matter matter matter pH 4.5 4.7 NA 4.7 NA 4.54.5 4.7 4.6 4.7 4.6 4.5

TABLE 11 Acetate Upright Inverted n = 2 0 1 M 3 M 6 M 9 M 12 M 0 1 M 3 M6 M 9 M 12 M Label 105.2 107.8 NA 107.9 NA 108.6 105.2 108.2 110.1 108.1107.1 108.2 Claim (%) Impurities 0.09 0.09 NA 0.10 NA 0.09 0.09 0.090.09 0.10 0.09 0.09 (%) Total 0.09 0.09 NA 0.10 NA 0.09 0.09 0.09 0.090.10 0.09 0.09 Impurities (%) Appearance Sample Sample NA Clear Samplesolution is Clear solution is solution is solution, transparent, novisible solution, no transparent, transparent, no visible particulatematter visible no visible no visible particulate particulate particulateparticulate matter matter matter matter pH 4.0 4.2 NA 4.1 NA 4.0 4.0 4.34.1 4.1 4.1 4.0

As can be seen, romidepsin liquid concentrate injection in citratebuffer and romidepsin liquid concentrate injection in acetate buffermaintained physical and chemical stabilities at −85° C. to −70° C. forup to 1 month (Table 8), at −25° C. to −10° C. for up to 1 month (Table9), and at 5° C.±3° C. up to 12 months (Tables 10 and 11).

Table 12 demonstrates the test results for romidepsin liquid concentrateinjection in citrate buffer stored at 25° C.±2° C./60% RH±5% RH.

TABLE 12 Citrate Upright Inverted n = 2 0 1 M 3 M 6 M 9 M 12 M 0 1 M 3 M6 M 9 M 12 M Label 103.5 104.0 NA 103.9 NA 104.6 103.5 105.7 106.7 104.2102.7 104.4 Claim (%) Impurities 0.09 0.09 NA 0.09 NA 0.09 0.09 0.090.09 0.09 0.09 0.09 (%)¹ 0.06 0.09 0.06 0.08 0.09 Total 0.09 0.09 NA0.15 NA 0.18 0.09 0.09 0.09 0.15 0.17 0.18 Impurities (%) AppearanceSample Sample NA Clear Sample solution is Clear solution is solution issolution, transparent, no visible solution, no transparent, transparent,no particulate matter visible no visible no visible visible particulateparticulate particulate particulate matter matter matter matter pH 4.54.7 NA 4.8 NA 4.6 4.5 4.7 4.7 4.8 4.8 4.6

The results demonstrate that the romidepsin formulation in citratebuffer at 25° C.±2° C./60% RH±5% RH RH maintained its physical stabilityfor up to 6 months. No visible particulate matter was observed up to 12months. The label claim remained essentially unchanged while the totalimpurities increased from 0.09% to 0.16% and 0.15% at 6 months andfurther to 0.18% at 12 months for upright and inverted storagecondition, respectively (Table 12).

Table 13 demonstrates the test results for romidepsin liquid concentrateinjection in acetate buffer stored at 25° C.±2° C./60% RH±5% RH up to 12months.

TABLE 13 Acetate Upright Inverted n = 2 0 1 M 3 M 6 M 9 M 12 M 0 1 M 3 M6 M 9 M 12 M Label 105.2 107.8 NA 107.5 NA 106.9 105.2 107.8 109.6 107.6106.6 107.8 Claim (%) Impurities 0.09 0.09 NA 0.09 NA 0.09 0.09 0.090.09 0.09 0.09 0.09 (%) 0.07 0.05 0.06 Total 0.09 0.09 NA 0.09 NA 0.160.09 0.09 0.09 0.09 0.14 0.15 Impurities (%) Appearance Sample NA Sample¹ Clear Sample solution is Clear Clear solution is solution is ²solution, transparent, no visible solution, solution, transparent,transparent, no particulate matter no no no visible no visible visiblevisible visible particulate particulate particulate particulateparticulate matter matter matter matter matter pH 4.0 4.2 NA 4.2 NA 4.14.0 4.2 4.1 4.2 4.1 4.2 ¹Sample solution is transparent. No visibleparticulate matter. ²Some visible particulate matter are observed.

The results demonstrate that the romidepsin formulation in acetatebuffer at 25° C.±2° C./60% RH±5% RH maintained its physical stabilityfor up to 6 months. Visible particulate matter was observed at 9 months,however, no visible particulate matter was observed at 12 months. Thelabel claim remained essentially unchanged for up to 6 months. The totalimpurities remained at the level of 0.09% after 6 months of storage at25° C.±2° C./60% RH±5% RH, and increased to 0.16% and 0.15% at 12 monthsfor upright and inverted storage conditions, respectively (Table 13).

Table 14 demonstrates the test results for romidepsin liquid concentrateinjection in citrate buffer stored at 40° C.±2° C./75% RH±5% RH up to 6months.

TABLE 14 Citrate Upright Inverted n = 2 0 2 W 1 M 3 M 6 M 0 2 W 1 M 3 M6 M Label 103.5 103.3 104.7 104.9 96.9 103.5 103.3 105.2 104.8 97.7Claim (%) Total 0.09 0.09 0.16 0.50 2.43 0.09 0.09 0.17 0.52 2.21Impurities (%) Appearance Sample solution is transparent, no visibleSample solution is transparent, no visible particulate matterparticulate matter pH 4.5 4.7 4.9 4.9 4.8 4.5 4.7 4.9 4.9 4.7

The results indicate that no visible particulate matter was observed forthe romidepsin formulation in citrate buffer maintained at 40° C.±2°C./75% RH±5% RH for up to 6 month. However, the pH value increased from4.5 to 4.7 at 2 weeks and further to 4.9 at 1 month. Label claim of theromidepsin formulation in citrate buffer remained essentially unchangedup to 3 months, but decreased from 103.5% at 0 time to 96.9% and 97.7%at 6 months for upright and inverted storage conditions, respectively.The total impurities remained 0.09% at 2 weeks, but increased to 0.16%and 0.17% at 1 month and further to 2.43% and 2.21% at 6 months forupright and inverted storage conditions, respectively (Table 14).

Table 15 demonstrates the test results for romidepsin liquid concentrateinjection in acetate buffer stored at 40° C.±2° C./75% RH±5% RH up to 6months.

TABLE 15 Acetate Upright Inverted n = 2 0 2 W 1 M 3 M 6 M 0 2 W 1 M 3 M6 M Label 105.2 106.7 107.3 108.7 104.3 105.2 107.0 106.3 108.3 104.8Claim (%) Total 0.09 0.09 0.09 0.36 1.43 0.09 0.09 0.09 0.35 1.21Impurities (%) Appearance Sample solution is Some visible Samplesolution is Some visible transparent, no visible particule mattertransparent, no visible particule matter particulate matter particulatematter pH 4.0 4.2 4.2 4.2 4.1 4.0 4.2 4.2 4.2 4.1

The results have shown that visible particulate matter was observed forthe romidepsin formulation in acetate buffer at 3 months and 6 monthsstored at 40° C.±2° C./75% RH±5% RH. The pH value remained essentiallyunchanged. Label claim of the romidepsin formulation in acetate bufferremained essentially unchanged at 40° C.±2° C./75% RH±5% RH for up to 6months. The total impurities remained at 0.09% level after 1 month ofstorage at 40° C.±2° C./75% RH±5% RH, but increased to 0.36% and 0.35%at 3 month and further to 1.43% and 1.21% at 6 months for upright andinverted storage conditions, respectively (Table 15).

Based on 12 months stability data, the romidepsin liquid concentrateformulation in acetate buffer is more stable than the romidepsin liquidconcentrate formulation in citrate buffer due to lower total impuritycontent at accelerated storage condition.

All publications, patents, and patent applications mentioned in thisspecification are herein incorporated by reference to the same extent asif each individual publication, patent, or patent application wasspecifically and individually indicated to be incorporated by reference.

The present disclosure has been described above with reference toexemplary embodiments. However, those skilled in the art, having readthis disclosure, will recognize that changes and modifications may bemade to the exemplary embodiments without departing from the scope ofthe present disclosure. The changes or modifications are intended to beincluded within the scope of the present disclosure, as expressed in thefollowing claims.

The invention claimed is:
 1. A method of treating peripheral T-celllymphoma (PTCL) or cutaneous T-cell lymphoma (CTCL) in a subjectcomprising administering to the subject a formulation comprisingromidepsin in a concentration of 1 mg/mL to 10 mg/mL, propylene glycol(PG), ethanol (EtOH) and a citrate buffer, wherein said formulation isstable for at least 6 months at ambient temperature, and wherein theratio of PG, EtOH and the citrate buffer in the formulation is 70% ofPG, 20% of EtOH, and 10% of the citrate buffer, and wherein a pH of theformulation is in a range from 4.5 to 5.0.
 2. The method of claim 1,wherein the formulation comprising romidepsin is a unit dosage form. 3.The method of claim 2, wherein the amount of romidepsin is between 2 and20 mg per unit dosage form.
 4. The method of claim 1, wherein theconcentration of romidepsin is 5 mg/mL.
 5. The method of claim 1,wherein romidepsin is administered intravenously.
 6. The method of claim5, wherein a dose of romidepsin is in a range of between 0.5 and 28mg/m² body surface area is administered.
 7. The method of claim 6,wherein the dose of romidepsin is in a range of between 8 and 14 mg/m²body surface area.
 8. The method of claim 7 wherein the dose ofromidepsin is about 8 mg/m² body surface area.
 9. The method of claim 7,wherein the dose of romidepsin is about 10 mg/m² body surface area. 10.The method of claim 7, wherein the dose of romidepsin is about 12 mg/m²body surface area.
 11. The method of claim 7, wherein the dose ofromidepsin is about 14 mg/m² body surface area.
 12. The method of claim11, wherein the formulation is administered as an IV infusion over a 4hour period on days 1, 8, and 15 of a 28 day cycle.